Provider Demographics
NPI:1851565311
Name:GUAN, QISHENG (LI AC , OMD)
Entity Type:Individual
Prefix:
First Name:QISHENG
Middle Name:
Last Name:GUAN
Suffix:
Gender:M
Credentials:LI AC , OMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 N HOPE AVE STE 12
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93110-1687
Mailing Address - Country:US
Mailing Address - Phone:805-965-6070
Mailing Address - Fax:
Practice Address - Street 1:100 N HOPE AVE STE 12
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93110-1687
Practice Address - Country:US
Practice Address - Phone:805-965-6070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-16
Last Update Date:2018-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC7568171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAC7568OtherCALIFORNIA ACUPUNCTURE BOARD